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I am scared of having IV sedation

Hello Dr. Pinder,

Back for more help!
Thank you for your helpful advice last month regarding next steps for treatment. (I posted about having a lifelong fear of dentistry, halcion being ineffective and having several teeth needing root canals/fillings). Your reasons for having the work done made sense, thank you. Hope you don’t mind I’ve returned for more help.
My dentist and endodontist have refused to treat me again as the last time was so difficult and have referred me to a new dr who is insisting on IV sedation.

I am very afraid of consenting to this as I don’t know the dentist at all and don’t like the idea of not being able to remember anything as he insists on using midazolam. When I have asked questions about other medications (just using Demerol for example) or being worried about issues after like needing repeated bite adjustments and the possibility of increased sensitivity to the teeth and gums he’s working on he became irritated and said I was putting roadblocks in the way of treatment. I wasn’t intentionally being difficult, I just need to find some way to be comfortable consenting to what I would rather DIE than have to do…dental work.
To make matters worse he said there is a high probability given my level of anxiety that the IV sedation wont work and I will be forced to consider GA in a surgery center! Can that really happen or is he just trying to scare me?

I am in the US but was hoping you might have suggestions on what I could say or do to make this less frightening. I wish it was just a fear of needles or gagging but the everything about dental work upsets me. Absolutely everything! The lack of control, not trusting him, feeling a bit bullied as I have no say in what meds he will use and had to fight to only let him work on the left, fearing the discomfort after etc. It takes me right back to bad experiences in childhood which is why I’ve only gone to the dentist twice in 20 years until now. He is doing 8 teeth on the left side…4 top, 4 bottom at our first appointment in early January… if I don’t cancel first.

I don’t know if there is anything that anyone can say or do to help but I feel desperate and am consumed with fear and dread.
Thank you for taking the time to read this and for your consideration of my “dental dilemma.”
Kind regards and Merry Christmas.

What is coming over to me is that there are aspects of your treatment that you would like to control , and that without this assurance you are finding it impossible to trust the dentist .
in the Us dentists have to have special training for sedation dentistry , and can use certain drugs .
The most common and the safest is midazolam ( hypnovel here in the UK ) . The specialist dentist will know what drugs are the right ones and how to use them correctly , and you cant ask him to use something else .
He was right in a way that there are barriers for you , but may not be aware of the depth of the psychological issues that you have . Referring you for this if you were unable to tolerate treatment without it is the right thing to do .
What happened in the past is a form of Post Traumatic Dental Anxiety which can have effects for a lifetime , but at least you do have access to the help that you need .
I see quite a few patients like yourself , and when they have got over the barriers have been really happy that they did it . It takes courage , but the choice is to stay as you are ?
I hope this helps

Answer provided by: Dr Jennifer Pinder Retired
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